Sheryl
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Posts posted by Sheryl
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Please see this thread re vaccine availability.
https://aseannow.com/topic/1362237-covid-vaccines-for-children-where/
Note that the newest vaccine is not available anywhere in Thailand, and in many places the available vaccines are several generations (vaccine generations) old.
BPH has vaccine but I do not know which version.
The current strain is unusually infectious (more so than the already very infectious earlier strains) but also unusually mild in most cases. If you test positive nothing other than symptomatic treatment and isolating at home is needed unless you have specific risk factors. If you do have the latter, Paxlovid might be advised but I have no current info on its availability. Other antivirals more readily available don't do much to be frank.
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2 hours ago, anrcaccount said:
@Sheryl thanks for your usual sensible advice.
In my home countries (x2), which have very strong, well respected health systems, covid vaccines are not recommended for children under 18 without existing complex health conditions.
So for the vast majority of children, covid vaccines are not recommended.
Does Thailand offer different public health guidance?
Current Thai Pediatric Guidelines (2024) include vaccination of children but there is no mass vaccination campaign for anyone at this time let alone children.
As already mentioned Thailand also does not have the newest version of vaccine.
The government has really not formulated a coherent response to this latest outbreak yet. No new guidelines issued and if anything is being done on vaccine procurement it has not been publicized.
Given the recent study findings it can safely be said that there will not be any mass vaccination of children in Thailand unless the epidemiological or clinical picture significantly changes.
The main argument for mass COVID vaccination of children is not child health per se (though the benefits do outweigh the risk in children, the overall risk is is very low unless the child has other health problems) but epidemic control: children live in families and can easily infect other members some of whom may be elderly and/or high risk. Infections in childten -- easily acquired at school - can fuel spread of infection in the ovrerall population.
Public health / publicly funded disease control measures are one thing, individual clinical decision making is quite another. A number of vaccinations recommended by the Pediatric Society of Thailand are not (at least as yet) part of the public vaccine schedule, but they remain recommended and can be obtained, for a price, at private facilities. Parents can and do make individualized choices for their children. OP had a bad experience with severe COVID in one of his children some years backs and wants to vaccinate themboth now. Nothing wrong with that, even if there is no mass vaccination campaign underway or justification on public health grounds. Public health measures are basef on the iverall population and , of necessity, always take cost benefit into account, and (unfortunately) are also not exempt from political considerations.
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41 minutes ago, ronnie50 said:
The Doctor said the ATK tests can confirm infection within 24 hours before symptoms. I didn't know that, I thought the ATK tests were only positive if you already had some symptoms.
Some people are never symptomatic. Will still have positive test.
When the test turns positive depends on viral load. May be positive before symptoms or not until after, even a few days after in some cases. Retesting makes sense if there is strong suspicion and if the information is critical (for example if you or a family member are high risk, or if it would affect your behavior).
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44 minutes ago, NickyLouie said:
A female acquaintance took the same test a few days ago and of course posted the results on her Facebook page, her results showed 2 pos+ for Covid and Flu A/B
Does that seem correct ????
Not one or the other .....
Perfectly possible to have both.
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The tests OP refers to check for three things: COVID, influenza and RSV.
As to what difference it would make:
- between the 3 illnesses, none if the illness is mild and there are no high risk persons in the household. With all 3, one should take measures to avoid infecting others, keeping in mind that among the general public there are people at high risk, even if there are none in your household.
Between these 3 illnesses and common cold: it has implications for (1) measures one should take to avoid infecting others, since all 3 of these illnesses present a higher risk to certain groups of people than the common cold does and (2) risk of the illness worsening or causing complications.
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25 minutes ago, xylophone said:
I recall looking at this when doing my research and it looked promising.........
How long does UroLift last for BPH relief?
Like almost any treatment or procedure, the results (and their longevity) of UroLift for BPH can vary somewhat from patient to patient. Generally speaking, however, most men who are otherwise in good urologic health can expect their UroLift results to last for many years and, in some cases, indefinitely. The UroLift implants themselves are typically considered safe and appropriate as lifelong devices. Should a patient's BPH symptoms worsen or change over time, a revision procedure may help restore their initial results, or Dr. Kasraeian may recommend another treatment mechanism to provide the most adequate level of relief possible.
source: https://kasraeianurology.com/blog/how-long-can-the-results-of-a-urolift-procedure-last
I added the source, please do not post unsourced quotes.
Urolift has not been around enough to have data on very long term use. To date studies show only 5 year use data:
https://pubmed.ncbi.nlm.nih.gov/28646935/
Basically, about 14% of patients required and receive additional surgical intervention within a 5 year period. (Study only tells what percent had surgery, could have been additional ones with an indication for surgery who did nto receive it for one reason or another).
Note that improvements were statistically significant but not as complete & dramatic as some might expect, i.e. average 36% improvement in International Prostate Symptom Score, 52% improvement in BPH Impact Index Score. These are averages, and likely conceal considerable variation among patients i.e. there may have been some with dramatic improvement and some with little to none.
There are likely individual factors that may help predict which patients will get the most benefit from this, and that should be discussed in detail with a urologist with extensive experience in it. It is nto a panacea nor suitable for everyone.
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31 minutes ago, Na Fan said:
Thank you for the phenomenal response @Sheryl
The Bangkok hospital in Pattaya also has Comirnathy from Pfizer, and, as you say, only the adult dose. And they have not been offering (via email) to administer a partial dose.
I'll go talk to their infectious disease specialist and see what they say.
You've been super helpful, thank you!
Have a splendid weekend
Make sure it is Comirnaty XBB.1.5, as there are early versions still around.
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The newest vaccine ever brought into Thailand is the Pfizer-BioNTech Comirnaty XBB.1.5, and that, only some places have; the ones I know of are all in Bangkok. The newer 2024-2025 Pfizer vaccine is not available.
The XBB 1.5 vaccine will still be of some help especially in completely unvaccinated children who have never had COVID (these will be a minority, see below). Older vaccines, which might be all that one can find outside of Bangkok, might still help but are not approved in Thailand for children under current guidelines; only the Pfizer-BioNTech Comirnaty XBB.1.5 is approved for chldren under current Thai guidelines.
Last I heard (admittedly about year old info) these places had the XBB1.5:
Mahidol University Thai Travel Clinic
Queen Saovabha Memorial Institute
Bumrungrad Hosptal
Praram 9 Hospital
quite possible some other large private hospitals in Thailand now have it too
HOWEVER, these have only the adult formulation. As you likely know, the dosage for children is different from adults. 3 mcg dose for your 3 year old and 10 mcg dose for your 6 year old. The vaccine is otherwise the same and per the guidelines of the Thai Pediatric Society, if the pediatric formulation is unavailable, fractional dose can be used i.e., they can give a partial amount of adult dose vial. Therefore even if a hospital or clinic does not have the 3 or 10 mcg dose, they can use a partial quantity of the adult dose -- but you'd want to make sure they understand this and calculate correctly. And they will probably end up wasting most of the vial, which if quantities are scarce, they may be unwilling to do. Do not expect anyone answering phone or email to know this, they will likely answer only that they do not have the pediatric vaccine, which is technically true. Doctor may or may not be willing to partial dose from use adult vial , and it would take direct doctor order to make that happen. Which you may or may not be able to get.
While the official COVID vaccine guidelines have not so far changed, the current outbreak is of an extremely contagious but unusually mild (for most people) variant. A recent study found that 80% of young children in Thailand already have immunity to COVID. This study has not yet been peer reviewed or published in a scientific journal but it has been widely publicized in the general media and a Chulalongkorn researcher even took the unusual step of posting it on Facebook. While any change in guidelines remains to be seen, pretty much everyone knows about this finding and it will probably influence provider behavior/willingness to use a fractional dose from an adult vial to vaccinate a child if there are no special risk factors present.
If you have not already, you can try asking Bumrungrad and Praram 9. Do not ask if the have the pediatric vaccine (they don't); ask if they have Pfizer-BioNTech Comirnaty XBB.1.5 vaccine available. If they do, ask if they will administer fractional dose based on age to children (better yet, go and ask this in person -- Thais tend to always say no to anything they are unsure of, and whomever you could reach by phone or email will not be a decision maker).
If it is any comfort, your 6 year old, having already had COVID for sure, probably has good immunity and your 3 year old also likely (80% chance) has some immunity, and the current strains are much less severe than what was around when your now 6 year old got it.
Of course if either of your children has special risk factors due to chronic disease, or if there is an older person in the same household with unusual risk factor that needs to be protected, that changes matters and best to go see a pediatrician at a hospital you know has the XBB.1.5 vaccine in stock to press your case.
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3 hours ago, Lee4Life said:
Some pharmacists will also print you a prescription and stick it on the bag they put the meds in.
That is not s prescription it's a label.
By definition a prescription is a signed doctor order for a medication.
Neither doxycycline nor most other drugs require this in Thailand. However, drugs in their classification (Thai FDA Categiry D) can only be sold by a Grade 1 pharmacist. If there isn't one (either at all, or on duty at the time you go) legally they can't dispense to you. Nothing to do with your having a prescription it is a pharmacy issue.
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2 hours ago, Globenauta said:
Since your last reply, I’ve started tracking my urination frequency more precisely. It turns out I’m averaging about every 2.0 to 2.5 hours while awake, which is more reasonable than the 1–2 hours I initially estimated. That said, I still get that uncomfortable “need to hold” sensation and urgency, even shortly after going.
Still seems odd for such small enlargement. 26 ml is almost normal dize. I continue to suggest ruling out infection.
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3 hours ago, caligula123 said:
ahhh...great! i do think that would be the way to go...i did not know that TABLETS were available! ..that does help put my mind at ease..i dont have any problem if i need to go doctor and get one,but can you buy the 100mg tablets at any pharmacy that has them with no prescription? thanks again for the help.
Doxycycline does not require a ptescription in Thailand.
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3 hours ago, newbee2022 said:
No.
Doxycycline tablets (!) are available. !
Of course doxycycline is available but not in 20 mg dose which is what OP needs.
Thay are capsules not tablets.
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2 hours ago, Yellowtail said:
Camillian is pretty nice as I remember. My wife was there for prenatal care, but ended up having to transfer to Bangkok Hospital because the baby was six weeks premature.
Doing it without the anesthesia is better, I think.
You seriously do not want a colonoscopy without anesthesia.
Gastroscopy also unpleasang (choking sensation) ,but nowhere near as bad.
The Camelluan price is sbout as good as it getd private hospital wise.
37.4k package at MedPark.
https://www.medparkhospital.com/online-store/gastroscopy-colonoscopy-package
Colonoscopy can be gotten at Chulabhorn (govt hospital) for under 10k but I am not eure they will do a gastroscopy on demand. Unlike colonoscopy gastroscopy is not reommended for routine screening).
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This is indeed unavailable in Thailand.
It is technically illegal to import medications by mail without an FDA license which is very difficult to get. Some people do order from Indian pharmacies and in the past small quantities usually got through but I am seeing more reports of things stopped by customs these days.
Perhaps someone with very recent experience ordering online fom India could respond.
If it were me, I would just bring in a year's supply with me making sure adequate expiration date. However be aware that rule is just 30 day supply. They do not ususlly count out the numbet of pills (indeed do not ususlly check luggage, period) but a small risk exists that supply in eccess of 30 days might be confiscated. I have heard of this happening only a few times in some 20 years on this forum.
Make sure the pills are clearly labelled so as not to be confused with a contolled substance.
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54 minutes ago, hotandsticky said:Would you comment on the suitability of the proposed treatment?
Use of ivermectin in prostate cancer is still in very early stages of investigation. No human trails yet, still long way off much less an approved protocol.
But I think OP knows this. And he did not ask for opinions on its use, he asked where to get it.
That info has been supplied.
As long as he does not forego conventional treatment banking on this unproven, undeveloped therapy, it is unlikely to hurt.
Thread therefore closed as going way off topic.
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https://bangkokdrugstore.com/product/iver-6-ivermectin-6-mg-box-of-12-tablets/
1,200 baht for 12 tablets of 6 mg
You should also ask Medisafe
(use the messenger function)
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Pink eye (if that is what you ،have) is often viral. But antibiotic drops may stiill be given as secondary bacterial infections can occur.
It can easily last 2 weeks.
If it goes much beyond that, an allergic rather than infective origin may need to be considered.
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Completely off topic posts removed. Thread closed. OP please feel free to start another if needed after you have seen Dr.
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16 hours ago, Globenauta said:Thanks, Sheryl,
I actually asked the urologist during my recent appointment whether an infection could be part of the problem. He said it was theoretically possible but didn’t seem too inclined to investigate further once I mentioned I had recently done an STD panel.
The panel included Chlamydia, Gonorrhea, Mycoplasma, Ureaplasma, Trichomonas, HSV 1 & 2, Candida, and a few others that all came back negative. Would that be enough to rule out a prostate infection or urethritis?
I’m based in Samut Prakan, by the way.
Thanks again, very helpful advice.Most common cause of prostatitis is E. Coli, which an STD panel would nto detect.
Also, depending on the type of test done, there can be false negatives esp for chlamydia.So you still need to rule out prostatitis IMO. It is just not usual for mild BPH to cause the degree of urinary frequency you describe. Add to that the lack of relief from tamsulosin, and suspicion of an infection rises.
This doctor is not too far from Samut Prakan and has been recommended by other board members
https://www.sukumvithospital.com/doctorprofile.php?id=188&lang=en
Ideally you want toi get a prostate massage to express prostatic fluid then a culture and sensitivity
As for your BPH: iti s a progressive condition and it worsens with age, but how fast varies greatly. One of the 2 classes of medication used for it can help reduce prostate size/slow growth. These are the 5-alpha reductase inhibitors, such as finasteride and dutasteride. It takes 6-12 months to see the therapeutic effect of these drugs, and they do unfortunately sometimes worsen ED. When they do, sometimes this effect eases up with continued use and sometimes not.
The other class of drugs used for BPH are alpha antagonists, such as tamsulosin and doxazosin. These do nto affect oprostate size but rather give symptomatic relief from blockage by relaxing the smooth muscles in the prostate and bladder neck. Unlike the first class of drugs, action is almost immediate. You already tried this class of drug without relief.
Cialis is also sometimes used to relax the muscles around the bladder neck and prostate, likewise only symptomatic relief. And of course, for ED.
Since the 5-alpha reducatse inhibitors do, over time, reduce the size of the prostate and slow progression of BPH, you could ask doctor about a daily regimen of Cialis plus finasteride or dutasteride as a way of potentially off-setting the negative effect of the latter on erectile function. May or may not work, and may or may nto be suitable i nthe context iof your overall medical history.
Urolift is nto widely available here, just a few places and doubt any doctor would do it for mild case of BPH. Like all treatments, it has potential side effects.
Some people feel that saw palmetto and/or milk thistle supplements help with BPH, others don't, and there is a lack of clear evidence either way. No harm in trying.
But above all, I suggest you rule out potential infection as your urinary frequency is unusual from mild BPH.
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Before going into the BPH issue, I have to wonder if you might have an undiasgnosed prostate infecton or urethitis.
Needing to per every1-2 hours seems inconsistent with your degree of BPH.
Might be worth getting a second opinion during which you specifically ask about cultures.
Where are you located?
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Perfectly normal to get up once or twiceto pee.
Some people are lighter sleepers than others so more easily awoken by bladder pressure. And of course fluid intske is a factor.
Getting up to pee per se should not be a concern. What is important is
1. Whether you can easily initiate the flow and fully empty your bladder when you do.
2. Whether urge to pee occurs only when bladder is actually full/nearly full.
2. Whether there are other symotoms like leg/feet swelling swelling during the dsy or shortness of breath.
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Fear of Sleep --> sleep apnea
in Health and Medicine
Posted
Yes, weight loss will do a lot.
I take it the results were of a follow up test after using the machine. What do you mean by results being "spot on". Were they improved over baseline?